Provider Demographics
NPI:1366090581
Name:METRO EAST COMMUNITY CARE, LLC.
Entity type:Organization
Organization Name:METRO EAST COMMUNITY CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:SHOULARS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MA
Authorized Official - Phone:609-837-3147
Mailing Address - Street 1:59 MAIN ST STE 206B
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5333
Mailing Address - Country:US
Mailing Address - Phone:609-837-3147
Mailing Address - Fax:973-273-4333
Practice Address - Street 1:59 MAIN ST STE 206B
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5333
Practice Address - Country:US
Practice Address - Phone:609-837-3147
Practice Address - Fax:973-273-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251300000XAgenciesLocal Education Agency (LEA)
No251C00000XAgenciesDay Training, Developmentally Disabled Services